Hyperlipidemia occurs when the body is unable to control its pool of lipids to maintain levels within optimal physiological ranges. This condition usually results from a disordered regulatory system that disrupts the activity of the various proteins involved in lipid metabolic pathways, thus altering the balance between lipid biosynthesis and clearance. Familial hypercholesterolemia (FH) affects approximately 1 in 500 people (approximately 10 million world-wide) and the elevated serum cholesterol concentrations associated with it is responsible for more than 50% risk of fatal or non-fatal coronary heart disease by age 50 in men and at least 30% in women aged 60 and above. The prevalence of hypercholesterolemia in Jamaica is estimated at 31%. Hypercholesterolemia is implicated in many cardio-vascular diseases affecting people worldwide and pose tremendous burden on the global healthcare system. In the last decade, cardiovascular disease (CVD) has become the leading cause of death across the Caribbean and accounted for 19% of deaths overall in 1995.
Citrus fruits have been known since antiquity to exhibit several beneficial effects in humans (Gorinstein et al. 2001). The traditional use of citrus in the treatment of cardiovascular diseases such as atherosclerosis, circulation dysfunction and high cholesterol is well documented (Oliver-Bever 1986; Rogar 2002). Over the past decade several studies have sought to elucidate the health-promoting principles in citrus fruits with the aim of utilizing them in ameliorating the metabolic defects that accompany several diseases and disorders such as cancer, diabetes and hypercholesterolemia. The major conventional drugs used to treat hypercholesterolemia include the statins (Lovastatin, Pravastatin, Simvastatin etc.) and Niacin (Nicotinic acid). Although these drugs are effective in lowering serum cholesterol levels, they result in several adverse effects. Statins for example result in gastrointestinal upset, muscle aches, and hepatic injury. Rarer problems are myopathy (defined as muscle pain with serum creatine kinase concentrations of more than 1000 Upper liter), rash, peripheral neuropathy, and insomnia. Niacin also results in adverse effects including flushing, abdominal pain, vomiting, headache, or elevated serum aminotransferase levels indicating liver damage.
Studies have shown that Ortanique peel polymethoxylated flavones extracts displayed potent hypolipidemic efficacy without the side effects of conventional hypolipidimic drugs (Green et al., 2011, Green et al., 2012). It is therefore conceivable that this extract can be used to develop a wide range of nutraceutic and pharmaceutic products with hypolipidemic efficacy. It is therefore necessary to develop a cost-effective and commercially viable method of extracting and producing the starting material for developing these products.